Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2013
Factors influencing blood loss and postoperative morbidity in children undergoing craniosynostosis surgery: a retrospective study.
Craniosynostosis is a condition resulting from the premature fusion of cranial sutures. Corrective surgery is often associated with a large amount of blood loss, with transfusion of red blood cells (RBC) and fresh frozen plasma (FFP). The aims of this study were to determine the variables associated with increased blood loss and postoperative complications. ⋯ Severe blood loss occurred in all children who underwent craniosynostotic corrections. Furthermore, the duration of surgery, patient weight and certain surgical procedures correlated with greater blood loss. Careful hemodynamic monitoring and evaluation of a patient's hematocrit value and volume status together may be helpful in maintaining the balance between insufficient and excessive blood product transfusion.
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Pediatric neurosurgery · Jan 2013
In vivo analysis of cervical range of motion after revised C1-C2 pedicle screw technique for pediatric atlantoaxial instability.
The purpose of this study was to analyze the cervical range of motion (ROM) after revised C1-C2 pedicle screw fixation for pediatric patients with atlantoaxial instability. ⋯ As a short-segmental fixation technique, revised C1-C2 pedicle screw fixation can provide effective biomechanical stability. Final follow-up cervical ROM is significantly increased through alleviating cervical pain and symptoms of myelopathy after surgery and possible subaxial compensation.
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Pediatric neurosurgery · Jan 2013
ReviewResting-state functional MRI in pediatric epilepsy surgery.
Resting-state functional MRI (rs-fMRI) identifies resting-state networks (RSN) in the human brain by analyzing the connectivity of anatomically remote neuronal populations with synchronous low-frequency fluctuation in blood oxygen level-dependent (BOLD) signal. Network analysis has informed the understanding of functional brain organization and is beginning to reveal the impact that neurological disorders such as epilepsy may have on the developing cerebral cortex. ⋯ Functional mapping of RSN is a promising tool that may help circumvent the challenges of adequate cooperation and limited abilities of developmentally disabled children to perform age-appropriate functions. We discuss the current methodology of rs-fMRI in the pediatric population, review the literature of rs-fMRI in pediatric epilepsy and present our experience of using rs-fMRI for functional network mapping in children undergoing epilepsy surgery.
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Pediatric neurosurgery · Jan 2013
The surgical outcome of traumatic extra-axial hematomas causing brain herniation in children.
The aim of this study was to assess the surgical outcome and prognostic importance of clinical and radiological data from children operated on under emergency conditions due to an extra-axial hematoma causing brain herniation. ⋯ Brain herniation is a serious consequence of traumatic extra-axial hematomas in children, and approximately one third of these patients have the potential for a favorable outcome. We recommend postoperative ICP monitoring to predict outcome and early decompressive surgery when possible for promising results.
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Pediatric neurosurgery · Jan 2013
ReviewPediatric neurosurgery patients need more than a neurological surgeon: a clinical experience.
The Division of Pediatric Neurosurgery of the University of Florida College of Medicine Jacksonville initiated and developed a multidisciplinary comprehensive team for the management of patients with a neurosurgical condition other than spina bifida. This report relates the rationale and stages of development of a multidisciplinary team to facilitate the health care and special needs of these children.